INTRODUCTION: Since 2006, the Advisory Committee for Immunization Practices (ACIP) has recommended routine vaccination of adolescent girls at ages 11 or 12 years with 3 doses of human papillomavirus (HPV) vaccine to prevent cervical cancer. Cervical cancer disparities exist for several populations in the United States. The topic is scantly documented in scholarly literature with modest knowledge of the uptake of the HPV vaccine in the Delta region. AIM: To examine the HPV vaccination coverage estimates in the counties and parishes that comprise the Delta Regional Authority (DRA) and compare with other non-DRA counties or parishes and the rest of US. This will provide vaccination coverage estimates for adolescent females in the DRA designated Delta region that will provide public health professionals with data for policy and programmatic decision-making. METHODS: We combined data from multiple survey years (2008-2012) from the National Immunization Survey-Teen (NIS-Teen). We conducted bivariate analyses to describe the distribution across selected socio-demographic characteristics and multivariable logistic regression models to produce adjusted prevalence ratios. RESULTS: Teens in the DRA had lower HPV vaccine initiation and completion rates compared to Non- DRA counties or parishes and the Rest of the US. The 3-dose HPV vaccination series completion rate among those who had initiated HPV vaccination and had 24 weeks between their first dose and the NIS interview date was 60.9% (95% CI: 55.8 – 65.8) among adolescent females in the DRA compared to 66.9 (95% CI: 63.7-70.0) of adolescent females in the Non-DRA counties and 67.6% (95% CI: 66.2-69.0) in the rest of the US. CONCLUSION: The low HPV vaccination coverage among adolescents in the DRA showed that it is important to implement additional strategies to increase HPV vaccination coverage that will prevent cancers associated with HPV in the DELTA Region. Stronger provider recommendations and awareness are important for increasing HPV vaccine uptake.

Introduction: In 2007 Ontario implemented a grade 8 quadrivalent human papillomavirus (qHPV) vaccination program targeting the virus that causes cervical cancer. Despite being 6 years post-implementation, few post-licensure studies have assessed the safety of the qHPV vaccine in this adolescent population. Since autoimmune disorders are often targeted for post-marketing surveillance by regulatory agencies, it is important to assess the risk of developing an autoimmune disorder post-qHPV vaccination. Objectives: The objectives of this thesis were to assess the risk for developing an autoimmune disorder following qHPV vaccination, assess for effect modification by the presence of predisposing risk factors, identify the period of highest risk and explore the risk for individual autoimmune disorders. Methods: A population-based retrospective cohort of girls eligible for Ontario’s qHPV vaccination program was identified using population-based databases. The risk of autoimmune disorders following qHPV vaccination was ascertained using the self-controlled case series method. Results: The risk of developing a new autoimmune disorder, adjusted for age, seasonality, concurrent vaccines and infections was 1.28 (95% CI: 0.87 – 1.89), and this association was independent of a history of immune-mediated disorders (p=0.39). The risk was not increased during days 7-24 post-vaccination (adjusted RR = 0.87, 95% CI: 0.43 – 1.74), but appeared to increase thereafter (adjusted RR = 1.36, 95% CI: 0.77 – 2.41 and RR = 1.62, 95% CI 0.94 – 2.78 respectively, for days 25 – 42 and days 43 – 60), although these differences were non-significant. The risk may be increased for certain disorders including Bell’s palsy (RR = 2.30, 95% CI: 0.67 – 7.95), systemic autoimmune rheumatic disorders (RR = 1.84, 95% CI: 0.42 – 8.02), Hashimoto’s disease (RR = 1.39, 95% CI: 0.46 – 4.22), and juvenile rheumatoid arthritis (RR = 1.31, 95% CI: 0.83 – 2.08), although none of these associations were statistically significant. Conclusion: This thesis demonstrated that no statistically significant increased risk for autoimmune disorders following qHPV vaccination was detected. However, there remains some uncertainty about the safety of the qHPV vaccine for a subset of the autoimmune disorders. The results from this analysis need to be pooled with those of other studies to confirm whether these are true safety signals. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2014-04-23 22:30:41.428

Persistent infection with certain subtypes of Human papillomavirus (HPV) is a necessary cause of cervical cancer, the second most common cancer among women worldwide. Uptake of HPV vaccines in the targeted Canadian female population has been lower than anticipated. This study’s primary objective was to determine undergraduate women’s perceptions about HPV vaccination. A total of 401 female University of Ottawa undergraduate students completed a newly developed cross-sectional web survey. The prevalence of HPV vaccination was 49%. While the overall attitude towards receiving the vaccine was positive, vaccinated respondents had more favorable attitudes toward the vaccine. Lack of vaccine knowledge and cost were the primary barriers that have prevented HPV vaccination among non-vaccinated respondents. Offering HPV vaccination for women aged 18 to 25 presents a strategy for addressing suboptimal vaccination coverage in the targeted female population and may reduce health inequities demonstrated by variations in cervical cancer incidence within jurisdictions.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Feb 10, 2009). Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 1994. / Vita. Includes bibliographical references (leaves [57]-62).

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [79]-87).

Thesis (Ph.D.)--Murdoch University, 2008. / Thesis submitted to the Faculty of Health Sciences. Inlcudes bibliographical references (leaves 241-286)

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 111-140).

Thesis (M.S.W.)--University of Wyoming, 2008. / Title from PDF title page (viewed on June 23, 2009). Includes bibliographical references (p. 17-19).

Thesis (Ph. D.)--University of Washington, 1996. / Vita. Includes bibliographical references (leaves [66]-84).